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06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
318
Comorbidity Burden and Adverse Outcomes After Transcatheter Aortic Valve Replacement
Daniel R Feldman1, Mikhail D Romashko2, Benjamin Koethe3
1Department of Internal Medicine Tufts Medical Center Boston MA.
Journal of the American Heart Association
|May 7, 2021
Summary
High comorbidity burden impacts outcomes after transcatheter aortic valve replacement (TAVR). Standard risk scores don't fully capture these risks, suggesting a need for better comorbidity assessment in TAVR patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Transcatheter aortic valve replacement (TAVR) is a primary treatment for symptomatic aortic stenosis in high-risk patients.
- Non-cardiac causes and comorbid conditions significantly influence mortality post-TAVR.
- The impact of comorbid conditions on TAVR outcomes requires further investigation.
Purpose of the Study:
- To investigate the prevalence of comorbid conditions in TAVR patients.
- To assess the association between chronic conditions and short- and medium-term outcomes following TAVR.
Main Methods:
- Retrospective single-center study of 341 patients undergoing TAVR (January 2015 - October 2018).
- Evaluation of 21 chronic conditions and their correlation with outcomes.
- Statistical adjustment for Society of Thoracic Surgeons (STS) predicted risk of mortality, age, and vascular access.
Main Results:
- 65% of patients had four or more chronic conditions.
- Each additional comorbid condition independently increased 30-day rehospitalization, a composite of 30-day rehospitalization/mortality, and 1-year mortality.
- A modest correlation (r=0.32) was found between STS score and comorbidity burden.
Conclusions:
- Comorbid disease burden is linked to poorer clinical outcomes in high-risk TAVR patients.
- Standard risk assessment tools inadequately reflect the risks posed by comorbidities.
- Systematic comorbidity assessment could enhance risk stratification for TAVR candidates.
Keywords:
cardiac diseasecardiovascular disease risk factorsclinical cardiologytranscatheter aortic valve implantationMore Related Videos
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